21/03/12

How good was it to go into ICU and see Jules sitting up in bed watching a movie on TV alert and coherent.  She was not on any sedation or pain relief, the congestion in her lungs was still causing her discomfort and her temperature was up a bit. and the ventilator was still assisting her breathing.

 The senior ICU consultant advised that her left lung was full of fluid and they were going to do a bronchoscopy see http://intensivecare.hsnet.nsw.gov.au/bronchoscopy to look inside the lung and then to suction out the congestion to clear the lung.  The procedure which is performed in the ward involves anaesthesia via sedative (Medazolam).  Jules had the procedure explained to her and consented.  Prior to the procedure the senior consultant explained what was being done and stressed that he was very confident that Jules would breathe on her own without the ventilator and tracheostomy at some time in the future.  The procedure was successfully performed and we were allowed to visit her after an hour or so.

On our return to the ward Jules was very agitated and disoriented she was insisting that the staff were trying to kill her and wanted to be moved to another hospital.  Apparently this was a side effect of the sedative, she had experienced this feeling before.  Fortunately we were able to explain what had happened to her and calm her and she was settled for the rest of the afternoon.  (Note from Val:  Margie and I were in with Julie after the bronchoscopy, and experienced Julie's agitation first.  We weren't successful in calming her down.  We got Norm, and he was fantastic at reassuring Julie by explaining what had happened to her, and that it was a side effect of the sedative - the head doc just stood aside in amazement at Norm's ability to explain the procedures to Julie, and to eventually calm her down.) They do not intend to use the Medazolam again.  The intention is to keep her quiet but with minimum sedation and pain relief for the next day or so and to give her some diazepam around 8-9PM to help her get a good nights sleep

 She asked about work and to have the newspaper read to her which I did until she tired.  It was good to see her interested in the outside world.

 The OT performed the ranging exercises on her arms and wrists and fingers, these keep the muscles and joints mobile and let them measure the sensation and what movement she has.  She has sensation and weak movement in both lower arms and no sensation or movement in hands and fingers as yet.  The OT also performed cognition tests which involved asking questions to determine how her short term and long term memory is and her understanding of her situation.  These tests are done daily .  She showed good awareness and understanding.  picture recognition will be included in this procedure from today.

 Jules also had two sessions of physio to help her clear her lungs, this is hard work for her but she accepts it and works with the therapist and nurse

 Val and Margie assisted the nurse in giving Jules a sponge bath and moisturised her skin.

 She also had an ultrasound on her injured knee, this did not indicate any DVT.  The swelling and bruising around the knee is slow to subside because of the lack of mobility.  The stitches have been removed fron the laceration and it is healing well

 She also complained of a sore ear and the ENT doctor checked her ear and found no obstruction or wax.

 It was a long tiring day for her  and she was looking forward to getting a good nights sleep albeit assisted.  Val and I left about 8:20PM exhausted.

We will update you all further tomorrow.

Kind regards Val, Norm, Kylie and Darrel